Many orthopaedic surgeons in the UK do not believe they are adequately trained in radiation safety. There is a deficiency amongst practicing surgeons in basic knowledge, relevant legislation and practicalities of the use of ionising radiation in the operating room. This could potentially put patients and health-care professionals at additional risk. We recommend that a standardised national training programme on the basic principles and safety of ionising radiation is implemented for all practicing orthopaedic surgeons.
This paper is the first UK national survey amongst orthopaedic surgeons and is one of the largest reported internationally.
This paper is the first UK national survey amongst orthopaedic surgeons and is one of the largest reported internationally.To evaluate the clinical benefits of Moses technology compared to the regular mode with the Lumenis® Pulse™ P120H holmium laser during ureteroscopy for stone disease.
An IRB approved database of patients with urolithiasis was analyzed for ureteroscopies from 1/2020 - 12/2020 at an outpatient surgery center. Patients who underwent ureteroscopy with the Lumenis® Pulse™ P120H holmium laser system with the Moses or regular mode were included. Patient characteristics and stone parameters were collected. Operative room parameters were compared including procedural time, fragmentation/dusting time, lasing time and total energy used. Complication rates and stone free rates were also analyzed. Univariate analysis and MANCOVA controlling for cumulative stone size were performed. Patients with staged procedures were excluded.
Of 197 surgical cases, 176 met inclusion criteria. Moses was utilized in 110 cases and regular mode in 66. There was no difference in cumulative stone size between Moses and regular modes (11.8±7.9 vs 11.6±9.2 mm, p=0.901). Procedural time (43.5±32.1 vs 39.8±24.6 min, p=0.436), fragmentation/dusting time (20.5±25.3 vs 17.1±16.1 min, p=0.430), lasing time (7.5±11.1 vs 6.7±7.9 min, p=0.570) and total energy used (5.1±6.7 vs 3.8±4.8 kJ, p=0.093) were also similar. Complications (6.4% vs 6.1%, p=0.936) and stone free rates (61.6% vs 73.5%, p=0.163) did not differ.
At our institution, Moses technology did not significantly change procedural time, fragmentation/dusting time, lasing time or total energy used. Moreover, there were no differences in complications or stone free rates. There may be technical benefits to Moses technology not captured in this analysis.
At our institution, Moses technology did not significantly change procedural time, fragmentation/dusting time, lasing time or total energy used. Moreover, there were no differences in complications or stone free rates. There may be technical benefits to Moses technology not captured in this analysis.Blood oxygenation-level dependent (BOLD) MRI may identify or quantify the regional distribution of hypoxia within a tumor. We aimed to evaluate the feasibility of BOLD MRI at 3 T in differentiating prostate cancer from benign tissue.
A total of 145 patients with biopsy-proven prostate cancer underwent BOLD MRI at 3 T. https://www.selleckchem.com/mTOR.html BOLD MRI was performed using a multiple fast field echo sequence to acquire 12 *-weighted images. The R2* value (rate of relaxation, s) was measured in the index tumor, and benign peripheral (PZ) and transition zone (TZ), and the results were compared. The variability of R2* measurements was evaluated.
Tumor R2* values (25.95 s) were significantly different from the benign PZ (27.83 s) and benign TZ (21.66 s) (&lt; 0.001). For identifying the tumor, the area under the receiver operating characteristic of R2* was 0.606, with an optimal cut-off value of 22.8 sresulting in 73.8% sensitivity and 52% specificity. In the Bland-Altman test, the mean differences in R2* values were 8.5% for tumors, 13.3% for benign PZ, and 6.8% for benign TZ. No associations between tumor R2* value and Gleason score, age, prostate volume, prostate-specific antigen, or tumor size.
BOLD MRI at 3 T appears to be a feasible tool for differentiating between prostate cancer and benign tissue. However, further studies are required for a direct clinical application.
The R2* values are significantly different among prostate cancer, benign PZ, and benign TZ.
The R2* values are significantly different among prostate cancer, benign PZ, and benign TZ.Robot-assisted laparoscopic partial nephrectomy (RAPN) for completely endophytic renal tumors is challenging because of the tumor complexity. The enucleation technique is an ideal resection method to maximally preserve the renal parenchyma. In the present study, we investigated the surgical outcomes of RAPN for completely endophytic renal tumors and compared them between the enucleation and standard resection techniques.
One-hundred-and-forty-four patients who underwent RAPN for completely endophytic tumors were the subjects of this study. The subjects were divided into two groups according to the surface-intermediate-margin (SIB) score enucleation group (SIB score 0-2) and standard resection group (SIB score 3-5). To minimize selection bias between the two surgical methods, patient variables such as age, sex, body mass index, American Society of Anesthesiologists score, tumor size, RENAL NS, and preoperative renal function were adjusted using 11 propensity score matching.
Of the 144 patients, 72 were ashowed better surgical outcomes for completely endophytic renal tumors in terms of preservation of renal function and operation time than the standard resection technique.This study aimed to evaluate the characteristics of ureteral access sheaths (UASs) that can reduce the insertion force while accessing the upper urinary tract.
Six different types of 12/14-Fr UASs were used. We evaluated the properties of UASs such as the diameter of the outer sheath, length of the inner dilator tip exposed from the outer sheath, sheath flexibility (assessed in terms of bending force of the tip or base), flexibility ratio (i.e., bending force value of tip-to-base ratio), and frictional force of the outer sheath surface. We measured the force required for inserting the UAS into an artificial ureteral model and examined the correlation between the relevant characteristics and insertion force for each UAS.
Overall, a lower tip-to-base flexibility ratio (r = 0.66) and a lower frictional force (r = 0.50) were inversely correlated with insertion force. The force of insertion into the bifurcation was associated with the flexibility of the base (r = -0.64), flexibility ratio (r = 0.79), and frictional force (r = 0.